It’s hard to keep up with all the health care legislation news lately. That’s why we’re providing regular summaries of the latest news, reflecting the current state of health care in the United States or how it may be changing in the not-too-distant future. Here’s a recap of some of the latest stories:
Senate Republicans Reveal “Discussion Draft” of Proposed Repeal and Replace Legislation
Senate Republicans released a Discussion Draft of proposed legislation to repeal and replace the Affordable Care Act on Thursday, June 22. Despite initial comments from Republican Senators indicating that the body would not closely follow the American Health Care Act (“AHCA”) recently passed by the House of Representatives, this draft closely tracks the policy in the AHCA.
The Discussion Draft includes several key policy improvements affecting employee health benefits and consumer directed health care.
As with the AHCA, the Discussion Draft would delay implementation of the “Cadillac Tax” until 2026; repeal the $2,600 contribution limit on Flexible Spending Accounts; and allow over-the-counter medications to be claimed as qualified medical expenses for HSAs, FSAs, and HRAs.
The most impactful changes are to HSAs. Proposed policy changes include:
- Increasing the annual contribution limit to the out of pocket maximum for HDHP ($6,650 for individuals and $13,300 for families in 2018);
- Allowing distributions for qualified medical expenses incurred between the effective date of a qualifying HDHP and establishment of an HSA if HSA is established within 60 days of HDHP effective date;
- Allowing catch-up contributions to same account by married spouses;
- Lowering the excise tax on non-qualified HSA distributions from 20% to 10%; and
- Defining over-the-counter medications as qualified medical expenses.
Senate Majority Leader Mitch McConnell (R-KY) has expressed his intention to introduce the Senate legislation for a vote next week. The Senate must wait for the Congressional Budget Office report on the legislation to proceed with a vote. The CBO score is expected early next week.
Majority Leader McConnell reportedly wants to bring the Bill to the floor before the Fourth of July recess whether or not it has the votes to pass in order to pave the way for tax reform.
President Trump Tweets Support of Discussion Draft, But Says Negotiation Necessary
Saying that “Obama Care is dead,” President Donald Trump praised the Discussion Draft saying that “It’s going to be very good… a little negotiation, but it’s going to be great.”
President Trump has also indicated that he wanted to “add some money” to the bill because he wanted it to have heart. President Trump’s comments come after calling the House-passed AHCA “mean.”
Conservative Senators Come Out Against Discussion Draft, Moderate Republican Express Reservations
Conservative Senators Ted Cruz (R-TX), Rand Paul (R-KY), Mike Lee (R-UT), and Ron Johnson (R-WI) came out against the Discussion Draft on Thursday. The Senators believe that the draft will not fulfill the promise that Republicans made to their voters – “to repeal Obama Care and lower their health care costs.”
The defection of these four senators would be fatal to the Discussion Draft as Republicans hold only 52 seats in the Senate and at least 50 votes are needed to pass the legislation with a tie-breaking vote from Vice President Mike Pence.
Moderate Senators Lisa Murkowski (R-AK), Shelley Moore Capito (R-WV), Dean Heller (R-NV), Rob Portman (R-OH), and Susan Collins (R-ME) have all expressed reservations about the legislation.
Senate Leadership will attempt to bridge the divide between Senate moderates and conservatives in coming negotiations.
While much policy is up for debate, the changes affecting employee benefits and consumer directed health care are widely popular in the Republican Caucus and unlikely to see any drastic alteration in future drafts.
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